Wide complex tachycardias examples: Difference between revisions
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[[File:VT with RBBB morphology.jpg|center|800px]] | [[File:VT with RBBB morphology.jpg|center|800px]] | ||
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Shown below is a patient with sinus tachycardia and WPW which mimics VT: | Shown below is a patient with sinus tachycardia and WPW which mimics VT:. ECG pedia suggests the 7 + 2 method: | ||
Following the 7+2 steps: | |||
Rhythm | |||
* '''This is a regular rhythm and every QRS complex is preceded by a p wave. The p wave is positive in II,III, and AVF and thus originates from the sinus node. Conclusion: sinus rhythm.''' | |||
Hartfrequency | |||
* '''Use the 'count the squares' method (a bit less than 3 large squares ~> 300-150-100), thus about 110 bpm and thus sinustachycardia.''' | |||
Conduction (PQ,QRS,QT) | |||
* '''PQ-interval=0.10sec (2.5 small squares), QRS duration=0.10sec, QT interval=320ms''' | |||
Hartaxis | |||
* '''Positive in I, II, negative in III and AVF. Thus a horizontal (normal) heart axis.''' | |||
P wave morphology | |||
* '''The p wave is rather large in II, but does not fulfill the criteria for right atrial dilatation.''' | |||
QRS morphology | |||
* '''The QRS shows a slurred upstroke or delta wave.''' | |||
ST morphology | |||
* Negative T wave in I and AVF. Flat ST in V3-V5. | |||
Compare with the old ECG (not available, so skip this step | |||
Conclusion? | |||
[[File:WPW with sinus tachycardia mimicking VT.jpg|center|800]] | [[File:WPW with sinus tachycardia mimicking VT.jpg|center|800]] | ||
Revision as of 21:46, 13 October 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Shown below are examples of wide complex tachycardias and their diagnosis:
VT with right bundle branch block morphology:
Shown below is a patient with sinus tachycardia and WPW which mimics VT:. ECG pedia suggests the 7 + 2 method: Following the 7+2 steps: Rhythm
- This is a regular rhythm and every QRS complex is preceded by a p wave. The p wave is positive in II,III, and AVF and thus originates from the sinus node. Conclusion: sinus rhythm.
Hartfrequency
- Use the 'count the squares' method (a bit less than 3 large squares ~> 300-150-100), thus about 110 bpm and thus sinustachycardia.
Conduction (PQ,QRS,QT)
- PQ-interval=0.10sec (2.5 small squares), QRS duration=0.10sec, QT interval=320ms
Hartaxis
- Positive in I, II, negative in III and AVF. Thus a horizontal (normal) heart axis.
P wave morphology
- The p wave is rather large in II, but does not fulfill the criteria for right atrial dilatation.
QRS morphology
- The QRS shows a slurred upstroke or delta wave.
ST morphology
- Negative T wave in I and AVF. Flat ST in V3-V5.
Compare with the old ECG (not available, so skip this step Conclusion?
